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Nutrition week 7

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winniesmith2's version from 2018-01-02 11:04

Section 1

Question Answer
Global distribution of breastfeeding at 12 months UK one of the lowest rates in Europe. High in low to MIC (middle income countries) developing countries. High in south Asia, west Asia and middle east, malyasia and south America- High. Mexico- High. Brazil, Russia, india, china - middle.
Prevalence of ever breastfeeding is increasing Prevalence of breast feeding is increasing, Due to WHO guidelines to exclusively breastfeed for 4 months and weening from 6.
Culture,background and social norms role in breasting feeding. Europe has the lowest breastfeeding rates but countries vary dramatically e.g. Scandinavia (norway, sweden and Denmark), 98% of women initiate breastfeeding and almost 50% maintain to 6 months - but not exclusive.
UK rates of exclusive breastfeeding at 4 months. 6%. 94% no longer exclusively breast feeding. - stands out as very low compared to other countries.
UK rates of excusively breast feeding at 6 months 0%. 25% complimentary breastfeeding
Exclusively breastfeeding stats for 6 months (unicef 2007-11)Followed by the minority. Vast majority less than 50%, world around 40%
Uk age at when breasting finished. before 2 weeks = 18/19%. by 4-10 weeks 33% - already a shift from mixed feeding to formula feeding.
Influences on feeding model -Maternal age; older breastfeed more. -Educational level; higher breastfeed more. -Ethnicity; some ethnic minority breastfeed more. -SES; higher socioeconomic status breastfeed more.
Social class of baby's father effecting % of women intending to breastfeedOld style analysis. Highest in social class 1 (educated group) and decreases as class decreases, classes 4/5.
Influences on feeding model; interactions. Interaction of these factors can be very individual e.g. the highly educated, high SES mother who has a demanding career breastfeeds less than the low SES poor mother can breastfeed more to save on the cost of formula or breastfeed less to go to work.
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Section 2

Question Answer
Breastfeeding advantages for babies1. Optimal form of nutrition for 6 months. 2. Lower risk of infection. 3. Protection against sudden infant death. 4. Superior brain function. 5. Protection against allergies. 6. Lower risk of obesity and related disorders in childhood and beyond.
Benefits for the infant; infection Evidence from developing countries shows that breastfed children are at lower risk of diarrhoeal and respiratory infections (major causes of death among under 5’s). Explain by; -No mixing of formula milk powder with infected water sources. -Human milk contains immunoglobulins, lactoferrin, B lymphocytes and macrophages which confer defence against pathogens.
Breastfeeding lowers risk of obesity; evidence Obesity journal; breastfeeding and childhood obesity; a systematic review. -Sample: N >69,000 from 9 studies. -Results: breast-feeding reduced the risk of obesity in childhood significantly adjusted odds ratio was 0.78, 95% CI (0.71, 0.85) -A dose-dependent effect of breast-feeding duration on the prevalence of obesity was reported in four studies. -Conclusion: Breast-feeding seems to have a small but consistent protective effect against obesity in children . Reduced the risk of obesity by 22%.
Benefit for the infant; brain development-Breastfed infants reported to have improved developmental scores (indices of neurodevelopment) . -Reports of improvements in IQ (confounded by other factors, e.g. better educated women are more likely to breastfeed). -Brain grows from 350g at birth to 1100g at 12 months .
Growth implication of exclusive breast feeding. WHO vs CDC WHO= standard. CDC= reference. Can compare the centiles (particularity outer centiles). The breastfed children tend to be smaller up to 18months and then grow into the 50th centile. Weight of breastfed child; lighter over first 2 years (weight gain slower = good).
Growth implications of breastfeeding Czech children VS who . Breastfed Czech infants are longer, with less weight and less weight for length. WHO infants were heavier and longer particularly in the lower centiles.
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Section 3

Question Answer
Age-related change in lean body mass and fat mass in males and females. When it gets to adolescent years, males lean body mass increases dramatically under testosterone produced by gonads, in response to gonadotrophins, which is released in response to gonadotrophin releasing hormone which is being released in response of the maturation of the hypothalamus. Females = increase in fat mass.
what effects Energy requirements -Related to body size and growth velocity rather than age. -Requirements greater in boys than girls due to greater lean body mass. -Must also sustain higher levels of physical activity. -Increase in appetite to deliver energy needs to: +Sustain optimal growth +Avoid excessive weight gain
What are the protein requirements -Major demands for protein: Sustain growth, Maintenance of existing tissues, Deposition of new lean mass, BUT utilisation for growth is dependent on an adequate energy intake. -Demands peak during pubertal growth spurt :11-14 girls and 15-18 boys -Intakes should be 12-14% of energy intake
What are the iron requirements Requirements for -Increase in lean body mass and synthesis of the muscle protein myoglobin -Increase in blood volume -Onset of menstruation in girls
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Section 4

Question Answer
Adolescents and food choices +Adolescence is a time of rapid growth and maturation -Optimal nutrition needed to maximize potential. +Adolescents attaining independence often have erratic or eccentric eating habits -Meal patterns -Food choices
Determinants of eating behaviour in adolescence; Environmental factors -Family lifestyle -Peer group -Sociocultural values -Family income -Media -Time pressures
Determinants of eating behaviour in adolescence; Personal factors -Food preferences -Beliefs and values -Emotions -Body image -Personal income -Nutrition-related knowledge -Sport and activity
Determinants of eating behaviour in adolescence; Health status -Chronic disease -Substance abuse -Psychological disorders
Dieting and weight control -Restriction of dietary intake is commonplace to control body weight. -Girls are more likely to indulge in such behaviors than boys: 20% and 50% of adolescents of either sex will attempt some sort of weight loss behavior. -Response to major changes in body size and shape associated with puberty: +Exposure to media items about body weight and dieting +Parental concerns about weight gain +Teasing from other children +Aspiration to share the dieting experiences of peers.
Prevalence of dieting behaviours 25% of overweight boys/girls, involve in dietary behaviours to loose weight, at a time when they natural gain weight. loosing battle= eating disorders. and 18% of non-overweight girls go on weight reduction diets. 5% of boys. - probably to specifically loose fat not lean body mass.
Adjusted odds ratios for eating disorders; Australian study; genderFemale 8 times more likely
Adjusted odds ratio for eating disorders; dieting during schoolintermediate; 6.7 times more likely. High; 16 times more likely (odds ratio)

hazard ratio; intermediate 4.9 times and severe dieting 18 times

Differences in the incidence of new eating disorders between sexes were largely accounted for by the high rates of earlier dieting and psychiatric morbidity in the female subjects.
In adolescents, controlling weight by exercise rather than diet restriction seems to carry less risk of development of eating disorders.
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